Department of Population Health, Division of General Internal Medicine, New York University School of Medicine, 227 E. 30th St., New York, N.Y. 10016, USA.
J Am Dent Assoc. 2013 Jun;144(6):627-38. doi: 10.14219/jada.archive.2013.0174.
Dental visits represent an opportunity to identify and assist patients with unhealthy substance use, but little is known about how dentists are addressing patients' use of tobacco, alcohol and illicit drugs. The authors surveyed dentists to learn about the role their practices might play in providing substance-use screening and interventions.
The authors distributed a 41-item Web-based survey to all 210 dentists active in the Practitioners Engaged in Applied Research and Learning Network, a practice-based research network. The questionnaire assessed dental practices' policies and current practices, attitudes and perceived barriers to providing services for tobacco, alcohol and illicit drug use.
One hundred forty-three dentists completed the survey (68 percent response rate). Although screening was common, fewer dentists reported that they were providing follow-up counseling or referrals for substance use. Insufficient knowledge or training was the most frequently cited barrier to intervention. Many dentists reported they would offer assistance for use of tobacco (67 percent) or alcohol or illicit drugs (52 percent) if reimbursed; respondents who treated publicly insured patients were more likely to reply that they would offer this assistance.
Dentists recognize the importance of screening for substance use, but they lack the clinical training and practice-based systems focused on substance use that could facilitate intervention. Practical Implications. The results of this study indicate that dentists may be willing to address substance use among patients, including use of alcohol and illicit drugs in addition to tobacco, if barriers are reduced through changes in reimbursement, education and systems-level support.
看牙医是识别和帮助有不健康物质使用问题的患者的一个机会，但对于牙医如何解决患者的烟草、酒精和非法药物使用问题知之甚少。作者调查了牙医，以了解他们的实践可能在提供物质使用筛查和干预方面发挥的作用。
作者向所有活跃于从业者从事应用研究和学习网络（一个基于实践的研究网络）的 210 名牙医分发了一份 41 项的网络调查。问卷评估了牙科实践的政策和当前实践、提供烟草、酒精和非法药物使用服务的态度和感知障碍。
143 名牙医完成了调查（68%的回应率）。尽管筛查很常见，但较少的牙医报告说他们提供后续咨询或转介治疗物质使用问题。缺乏知识或培训是干预措施中最常被引用的障碍。许多牙医报告说，如果得到补偿，他们将为烟草（67%）或酒精或非法药物（52%）的使用提供帮助；治疗有公共保险的患者的受访者更有可能表示他们会提供这种帮助。
牙医认识到筛查物质使用的重要性，但他们缺乏针对物质使用的临床培训和基于实践的系统，这些系统可以促进干预。实际意义。这项研究的结果表明，如果通过改变报销、教育和系统层面的支持来减少障碍，牙医可能愿意解决患者的物质使用问题，包括除烟草以外的酒精和非法药物的使用问题。
